Patient Radiation Dose Reporting (P-RDSR) Supplement is developed - - PowerPoint PPT Presentation

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Patient Radiation Dose Reporting (P-RDSR) Supplement is developed - - PowerPoint PPT Presentation

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Supplement 191: Patient Radiation Dose Reporting (P-RDSR) Supplement is developed by DICOM Working Group 28 (WG-28-Physics) Patient Radiation Dose SR (P-RDSR) Current Radiation Dose SR contains only information about the x-ray system or

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SLIDE 1

Supplement 191: Patient Radiation Dose Reporting (P-RDSR)

Supplement is developed by DICOM Working Group 28 (WG-28-Physics)

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SLIDE 2

DICOM WG-28 / Supp 191 2

Patient Radiation Dose SR (P-RDSR)

  • Current Radiation Dose SR contains only information about the x-ray

system or information the x-ray system can determine, e.g.:

  • radiation output, geometry, x-ray source, detector system, etc.
  • Estimation of patient/organ dose requires knowledge of:

– Radiation beam characteristics – Models of the patient/organs – Models of radiation interaction within the patient

  • Methods to do patient dose estimations are being developed and

improved continuously – storage of these estimations in a different object would allow more versatile utilization of the data

15 Sept 2016

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SLIDE 3

DICOM WG-28 / Supp 191 3

Patient Radiation Dose SR (P-RDSR)

  • Goals of the Patient Dose SR

– Store the results of Patient Organ Dose calculations:

–

  • f a SINGLE procedure or MULTIPLE procedures

– including one or more modalities and procedure steps/phases –

  • f one or more organs

– by one or more calculation methods

– Exchange intermediate results with peers

  • Examples of modalities and procedures:

Multi-modality, single procedure step

  • SPECT and PET/CT

– internal organ dose Single modality, multi-procedure step

  • CT

– internal organ dose – eye dose

  • XA/RF (multi time points being combined)

– skin dose map

  • XA localization / disgnostic plus intervention

– skin dose map – internal organ dose

  • Mammography/Projection X-ray

– Tomosynthesis Single modality, single procedure step

  • CT

– internal organ dose – eye dose

  • XA/RF (one time point)

– skin dose map – internal organ dose

  • Mammography

– glandular dose

  • Projection x-ray (CR/DX)

– entrance skin dose – internal organ dose

  • NM/PET

– internal organ dose

3 15 Sept 2016

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SLIDE 4

DICOM WG-28 / Supp 191

Patient Radiation Dose SR (P-RDSR)

Calculation Method 1

Radiation Dose SR 1

Organ 1

Patient Dose SR 1

Data flow – simple case

Dose Estimate #1:

  • Organ 1
  • RDSR Source 1
  • Method 1

4 4 15 Sept 2016

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SLIDE 5

One RDSR, multiple organs

Dose Estimate #1:

  • Organs 1, 2, 3
  • RDSR Source 1
  • Method 1

Calculation Method 1

Radiation Dose SR 1

Organ 1

Patient Dose SR 1

Organ 2 Organ 3

DICOM WG-28 / Supp 191 5

Patient Radiation Dose SR (P-RDSR)

15 Sept 2016

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SLIDE 6

Dose Estimate #1:

  • Organs 1, 2, 3
  • RDSR Source 1
  • Method 1

Dose Estimate #2:

  • Organs 1, 2, 3
  • RDSR Source 2
  • Method 1

Multiple RDSRs, multiple organs

Dose Estimate #3

  • Organs 1, 2, 3
  • RDSR Sources 1, 2
  • Method 1

Or combining RDSRs:

Calculation Method 1

Radiation Dose SR 1

Organ 1

Patient Dose SR 1

Organ 2 Organ 3

Radiation Dose SR 2

DICOM WG-28 / Supp 191 6

Patient Radiation Dose SR (P-RDSR)

15 Sept 2016

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SLIDE 7

Multiple RDSRs, multiple organs, multiple methods

Dose Estimate #5:

  • Organs 1, 2, 3
  • RDSR Sources 1, 2
  • Method 1

Dose Estimate #6:

  • Organs 1, 2
  • RDSR Sources 1, 2
  • Method 2

Dose Estimate #1:

  • Organs 1, 2, 3
  • RDSR Source 1
  • Method 1

Dose Estimate #2:

  • Organs 1, 2
  • RDSR Source 2
  • Method 1

Dose Estimate #3:

  • Organs 1, 2
  • RDSR Source 1
  • Method 2

Dose Estimate #4:

  • Organs 1, 2
  • RDSR Source 2
  • Method 2

Or combining RDSRs:

Calculation Method 1

Radiation Dose SR 1

Organ 1

Patient Dose SR 1

Organ 2 Organ 3

Radiation Dose SR 2

Calculation Method 2

DICOM WG-28 / Supp 191 7

Patient Radiation Dose SR (P-RDSR)

15 Sept 2016

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SLIDE 8

Radiation Dose SR

Radiation Exposure Information

  • X-Ray exposure techniques
  • Table, Gantry Angle, Beam Geometry, collimation
  • Dose measure: CTDI, DAP, ...

Modality Image Organ Dose Reporter System

Modality Frame of Reference (FOR)

X-Ray Equipment

Patient Dose Determination: Data Flow Requirements

DICOM WG-28 / Supp 191 8 Signifies part of Supplement 191 Patient RDSR

Patient Radiation Dose SR (P-RDSR)

15 Sept 2016

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SLIDE 9

Patient Model Registration IOD

Equipment Information

  • Table dimension
  • Attenuating material, …

Patient Model FOR

Patient Registration Information

  • Patient position on table
  • Fiducials
  • Registration matrix between Patient

FOR and Equipment FOR

Radiation Dose SR

Radiation Exposure Information

  • X-Ray exposure techniques
  • Table, Gantry Angle, Beam Geometry, collimation
  • Dose measure: CTDI, DAP, ...

Modality Image Organ Dose Reporter System

Modality Frame of Reference (FOR)

X-Ray Equipment

DICOM WG-28 / Supp 191 9 Signifies part of Supplement 191 Patient RDSR

Patient Radiation Dose SR (P-RDSR)

Patient Dose Determination: Data Flow Requirements

15 Sept 2016

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SLIDE 10

Patient Dose SR

Calculated data for documentation and reference to images and RDSR’s

Patient Dose 2D view/map (e.g. iso- dose map) Patient Dose Surface 3D map/view

Patient Model Registration IOD

Equipment Information

  • Table dimension
  • Attenuating material, …

Patient Model FOR

Radiation Dose SR

Radiation Exposure Information

  • X-Ray exposure techniques
  • Table, Gantry Angle, Beam Geometry, collimation
  • Dose measure: CTDI, DAP, ...

Modality Image Organ Dose Reporter System

Modality Frame of Reference (FOR)

X-Ray Equipment

Patient Registration Information

  • Patient position on table
  • Fiducials
  • Registration matrix between Patient

FOR and Equipment FOR

Signifies part of Supplement 191 Patient RDSR DICOM WG-28 / Supp 191 10

Patient Radiation Dose SR (P-RDSR)

Patient Dose Determination: Data Flow Requirements

15 Sept 2016

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SLIDE 11

Patient Model (3D image) Registration

Patient Model FOR

  • Table, position
  • Gantry Angle
  • Beam Geometry, collimation

Patient Images FOR

X-Ray Equipment

Registration between Patient Model and RDSR

DICOM WG-28 / Supp 191 11

X-Ray Images Radiation Dose SR (RDSR)

Registration matrix between:

  • each RDSR FOR and
  • the Patient Model FOR

                                         1 1 1

B B B 33 32 31 23 22 21 13 12 11 A A A

z y x T M M M T M M M T M M M z y x

z y x

Case #1 Patient Radiation Dose SR (P-RDSR)

15 Sept 2016

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SLIDE 12

Patient Model (3D image) Registration

Patient Model FOR

  • Table position vs. Isocenter
  • Gantry Angle vs. Isocenter
  • Beam Geometry, collimation

FOR

X-Ray Equipment

DICOM WG-28 / Supp 191 12

Equipment Fiducials Radiation Dose SR (RDSR)

Registration matrix between:

  • each RDSR Fiducial FOR and
  • the Patient Model FOR

TABLE TOP HEAD

                                         1 1 1

B B B 33 32 31 23 22 21 13 12 11 A A A

z y x T M M M T M M M T M M M z y x

z y x

Registration between Patient Model and RDSR Case #2 Patient Radiation Dose SR (P-RDSR)

15 Sept 2016

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SLIDE 13

Patient Fiducials Registration

  • Table position vs. Isocenter
  • Gantry Angle vs. Isocenter
  • Beam Geometry, collimation

X-Ray Equipment

DICOM WG-28 / Supp 191 13

Equipment Fiducials Radiation Dose SR (RDSR)

Registration matrix between:

  • each RDSR Fiducial FOR and
  • the Patient Fiducial FOR

FOR TABLE TOP HEAD FOR PATIENT TOP HEAD

                                         1 1 1

B B B 33 32 31 23 22 21 13 12 11 A A A

z y x T M M M T M M M T M M M z y x

z y x

Note: the patient fiducials can be defined through a manual measurent on the actual patient landmarks, or through image- based measurements of landmarks visible on the X-Ray images.

Registration between Patient Model and RDSR Case #3 Patient Radiation Dose SR (P-RDSR)

15 Sept 2016

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SLIDE 14

No Patient Model Registration

  • Table position vs. Isocenter
  • Gantry Angle vs. Isocenter
  • Beam Geometry, collimation

X-Ray Equipment

DICOM WG-28 / Supp 191 14

Radiation Dose SR (RDSR)

Free Text Comment: E.g. “Distance from Patient Head to Table Top Head is 15 cm”

No Equipment Fiducials No X-Ray Images

Registration between Patient Model and RDSR Case #4 Patient Radiation Dose SR (P-RDSR)

15 Sept 2016

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SLIDE 15

DICOM WG-28 / Supp 191 15

Patient Dose SR IOD Templates

TID prdsrT01 Patient Radiation Dose TID 1002 Observer Context TID prdsrT02 Dose Estimate TID prdsrT03 Dose Estimate Representation TID prdsrT04 Dose Estimate Methodology TID prdsrT05 Dose Estimate Parameters TID 1204 Language of Content Item and Descendants

Patient Radiation Dose SR (P-RDSR)

15 Sept 2016

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SLIDE 16

Ref. Ref.

1 1

Ref. TID prdsrT01 Patient Radiation Dose TID prdsrT02 Dose Estimate TID prdsrT03 Dose Estimate Representation Patient Dose Model X-Ray Beam Attenuator Information

Source Radiation Dose SR

Registration with RDSR

1-N 1-N

Radiation Dose Estimate Method

1-N 1 1 1 1

Ref. Organ Dose Information TID prdsrT04 Dose Estimate Methodology

1-N 1-N

TID 1204 Language of Content Item and Descendants TID 1002 Observer Context

1

TID prdsrT05 Dose Estimate Parameters

1

Dose Estimate Parameters

1-N Radiation Dose Estimation Parameter 1

  • Organ Name
  • Comment
  • Name
  • Comment

1 1

Dose Estimate Representation

  • Distribution Model
  • Comment

1-N 1 1 Organ 1-N

Template

Container Content Items

Legend:

Dose Estimate Methodology

1 Dose Representation Data 1

  • Patient Model Type
  • Radiation Transport Model Type
  • Patient Dose Model Reference
  • Comment

Patient Dose Model Data 1 1

Patient Model Demographics

1 Model Age, sex, weight, height 1

  • Registration Method
  • Comment

1 Registration

Ref.

  • Estimate Method Type
  • Estimate Method Reference
  • Material Category
  • Equivalent Material
  • Equivalent Thickness
  • Description

1

Attenuator Model

Registration with RDSR 1 1-N

  • Radiation Transport Types
  • Model Reference

1

  • Registration Method
  • Comment

1

Ref. Patient Radiation Dose Report

1

Patient Radiation Dose SR: Detailed Structured Content

DICOM WG-28 / Supp 191 16

Comment 1 Uncertainty info Equivalent Dose Absorbed Dose 1 1 Uncertainty info 1-N 1-N Radiation Dose CompositeParameter Comment 1 Source Dose SR Spat. Fiducials 1

Ref.

Attenuator Model Data 1 1 Registration

15 Sept 2016

1

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SLIDE 17

Author Contacts

  • Donald Peck, donaldp@rad.hfh.edu (editor)
  • Annalisa Trianni, trianni.annalisa@aoud.sanita.fvg.it
  • Heinz Blendinger, heinz.blendinger@siemens.com
  • Francisco Sureda, francisco.sureda@med.ge.com
  • Steve Massey, steve.massey@pacshealth.com
  • Ioannis Sechopoulos, ioannis.sechopoulos@radboudumc.nl
  • Ting Lu, ting.lu@bayer.com

DICOM Secretariat: dicom@medicalimaging.org

Thank you for your attention!

DICOM WG-28 / Supp 191 17 15 Sept 2016